Autism

What are the symptoms of autism?
If your child has autism, you will probably notice things that are different about them between the ages of 18 months and 2 years. But the signs may become clear even sooner than that. Or you may not notice them until later, when your child starts school.
Even very early on, you may notice that your child:
1
Usually, at about 9 months of age children will follow your finger when you point to something. And typically, children point
to something they want at about 1 year of age.
2
Source:
Johnson CP.
New tool helps primary care physicians diagnose autism early.
AAP News. 2004; 24: 74.
Johnson CP.
New tool helps primary care physicians diagnose autism early.
AAP News. 2004; 24: 74.
- Doesn't look when you call their name, even if they seem to hear other sounds
- Doesn't look you in the eye much or at all
- Doesn't notice when you enter or leave a room
- Seems to be in their own world
- Doesn't look where you do or follow your finger when you point to something
- Doesn't point at things.
Source:
Committee on Children with Disabilities.
Technical report: the pediatrician's role in the diagnosis and management of autistic spectrum disorder in children.
Pediatrics. 2001; 107: 85.
Committee on Children with Disabilities.
Technical report: the pediatrician's role in the diagnosis and management of autistic spectrum disorder in children.
Pediatrics. 2001; 107: 85.
Some other things you may notice are that your child:
1
Source:
Johnson CP.
New tool helps primary care physicians diagnose autism early.
AAP News. 2004; 24: 74.
Johnson CP.
New tool helps primary care physicians diagnose autism early.
AAP News. 2004; 24: 74.
- Doesn't smile back at you
- Leads you by the hand to tell you what they want
- Can't do simple things you ask them to do
- Has a lot of tantrums
- Wants to always hold a certain object, such as a flashlight
- Prefers to play alone
- Doesn't play with toys in the usual way
- Doesn't play pretend (if they are older than 2 years).
Source:
Wing L.
The autistic spectrum.
BMJ. 1996; 312: 327-328.
Wing L.
The autistic spectrum.
BMJ. 1996; 312: 327-328.
Source:
World Health Organization.
The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research.
1993. Available at http://www.who.int/classifications/icd/en (accessed on 21 April 2009).
World Health Organization.
The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research.
1993. Available at http://www.who.int/classifications/icd/en (accessed on 21 April 2009).
Source:
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
Even small babies take part in social activities. Within the first few months, babies look at faces and begin to smile, especially
when they are smiled at. Babies also like to be cuddled and comforted with words, sounds and singing.
If your child has autism, they may be much less eager than normal about these activities.
6 Some children don't like to be picked up or cuddled.
7 A child with autism may prefer to just lie in their crib or sit in a familiar chair rather than get attention. They usually
won't want to play with other children.
Source:
Volkmar FR, Pauls D.
Autism.
Lancet. 2003; 362: 1133-1141.
Volkmar FR, Pauls D.
Autism.
Lancet. 2003; 362: 1133-1141.
Source:
Folstein SE.
Autism.
International Review of Psychiatry. 1999; 11: 4.
Folstein SE.
Autism.
International Review of Psychiatry. 1999; 11: 4.
Children normally become very close to the main person who cares for them, usually their mother. And they get upset when this
person leaves them. But children with autism may not react in this way. In fact, they may not even have much interest in their
parents. This can upset you a lot if you are a parent. So can having a child who doesn't seem to give or need affection in
the usual way. Children with autism can show affection, but they do so in their own way.
Communication is a big word. It's just a term for telling other people what we mean. We tell others what we mean in lots of
different ways.
One way people communicate is by speaking. How much children with autism speak varies a lot. Some children say just a few simple phrases over and over, while others
speak almost normally. A few children don't speak at all.
About 1 in 6 children with autism speak only a word or two, once in a while.
8
9 And unlike children with some other kinds of problems, such as a hearing problems, children with autism don't try to make
signs either.
Source:
Lord C, Risi S, Pickles A.
Trajectory of language development in autistic spectrum disorders.
In: Rice M, Warren S (editors). Developmental language disorders: from phenotypes to etiologies. Lawrence Erlbaum Associates, Mahwah, U.S.A; 2004.
Lord C, Risi S, Pickles A.
Trajectory of language development in autistic spectrum disorders.
In: Rice M, Warren S (editors). Developmental language disorders: from phenotypes to etiologies. Lawrence Erlbaum Associates, Mahwah, U.S.A; 2004.
Source:
Charman T, Taylor E, Drew A, et al.
Outcome at 7 years of children diagnosed with autism at age 2: predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time.
Journal of Child Psychology and Psychiatry. 2005; 46: 500-513.
Charman T, Taylor E, Drew A, et al.
Outcome at 7 years of children diagnosed with autism at age 2: predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time.
Journal of Child Psychology and Psychiatry. 2005; 46: 500-513.
The other 5 in 6 children do learn to speak, but usually at a slower pace than normal. Most children without autism can use simple phrases of two or more words by the age of 2 years.
10 But if your child has autism, this might take much longer. Children with autism who are going to speak usually begin to do
so by the age of 5 years. But they may only talk about their interests or say the same things over and over.
7
Source:
National Institute on Deafness and other Communication Disorders.
Speech and language developmental milestones.
Available at http://www.nidcd.nih.gov (accessed on 21 April 2009).
National Institute on Deafness and other Communication Disorders.
Speech and language developmental milestones.
Available at http://www.nidcd.nih.gov (accessed on 21 April 2009).
Source:
Folstein SE.
Autism.
International Review of Psychiatry. 1999; 11: 4.
Folstein SE.
Autism.
International Review of Psychiatry. 1999; 11: 4.
Your child with autism may often say back words or phrases they have heard you say. This can be right after hearing it or
later. (But some children without autism do this too.) And your child may also have problems using the words "I" and "you"
in the right way.
Some children with autism learn to speak a bit in their first year. But then they lose that speech in their second year. In
other words, they seem to go backward. To learn more, see Autism and speaking.
People communicate in other important ways too. For example, we look each other in the eye and show an interest in what others
are saying. If your child has autism, they may not be able to do this naturally. And they may speak with a flat voice. Also,
your child may cut in when someone is talking or may not know when to give others a turn.
If your child has autism, they may have set ways of behaving that they do over and over. And they may be interested in only a few things. You can see this in the way that your child
plays. For example, your child may want to send a toy car up and down the ramp of their toy garage over and over. But they
won't want to play pretend. So they won't want to imagine going on a trip with their toy car.
If your child has autism, they may also need to have the same routines every day. The routine can have many steps, and they have to be done in the same order. Changing the routine in any way can
upset your child a lot, more than you expect.
Some children with autism are fascinated with things that work in complex ways, such as toys that are like machines. Drawing,
playing computer games or building with Lego blocks may be fun for some children with autism. But they often do or make the
same thing over and over.
Older children with autism may be unusually interested in very detailed facts. For example, they may get very focused on schedules for trains or on topics such as astronomy. Many children without autism
have particular interests too. But in children with autism, the interest is more than you expect.
More than 1in 4 children with autism have intelligence that is below normal.
11 This means they have problems with learning.
12 Some children do well on intelligence tests, but they may not be able to pay attention, to hold on to an idea while doing
something else or to make a decision quickly.
12
Source:
Chakrabarti S, Fombonne E.
Pervasive developmental disorders in preschool children.
Journal of the American Medical Association. 2001; 24: 3093-3099.
Chakrabarti S, Fombonne E.
Pervasive developmental disorders in preschool children.
Journal of the American Medical Association. 2001; 24: 3093-3099.
Source:
Baird G, Cass H, Slonims V.
Diagnosis of autism.
BMJ. 2003; 327: 488-493.
Baird G, Cass H, Slonims V.
Diagnosis of autism.
BMJ. 2003; 327: 488-493.
Source:
Baird G, Cass H, Slonims V.
Diagnosis of autism.
BMJ. 2003; 327: 488-493.
Baird G, Cass H, Slonims V.
Diagnosis of autism.
BMJ. 2003; 327: 488-493.
Some children with autism are very sensitive to sound. Your child may get upset by everyday noises, such as the sound of a vacuum cleaner. Or they may be able to hear sounds,
such as airplanes in the sky, long before others in the same room.
Your child may have a strong sense of smell or taste. And they may be a very picky eater, eating only a few foods or only foods made in a certain way.
Some children with autism don't seem to feel pain. But this may be because they don't know how to tell you when they are hurt or they won't come for comfort.
If your child gets excited, they may flap their hands and arms. Or they might move their arms with their elbows bent and fingers
in front of their face. Your child may be a bit clumsy. And they may rock, spin or bounce over and over.
Many children with autism are very active. You may hear this called hyperactive. This means it's hard for your child to focus or pay attention for very long. Your child may not be able to sit still and
may act before thinking. They may have problems sleeping too.
Some children with autism get anxious or depressed. Usually, this happens in older children and young adults. Also, some children
with autism hurt themselves. For example, they may bang their heads against a wall or bite their wrists.
5
Source:
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
All these problems can upset you and tire you out.
Children with autism may have a hard time writing with a pen or pencil. This can be very frustrating for your child. Using
a computer may help them get past this.
11
Source:
Chakrabarti S, Fombonne E.
Pervasive developmental disorders in preschool children.
Journal of the American Medical Association. 2001; 24: 3093-3099.
Chakrabarti S, Fombonne E.
Pervasive developmental disorders in preschool children.
Journal of the American Medical Association. 2001; 24: 3093-3099.
About 1 in 4 people with autism get
seizures.
5 But there are good treatments that can usually keep seizures under control.
seizure
A seizure is a sudden spasm of muscles caused by too much electrical activity in the brain. It results in muscle twitching and other symptoms.
A seizure is a sudden spasm of muscles caused by too much electrical activity in the brain. It results in muscle twitching and other symptoms.
Source:
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
Sources for the information on this page:
- Johnson CP.New tool helps primary care physicians diagnose autism early.AAP News. 2004; 24: 74.
- Committee on Children with Disabilities.Technical report: the pediatrician's role in the diagnosis and management of autistic spectrum disorder in children.Pediatrics. 2001; 107: 85.
- Wing L.The autistic spectrum.BMJ. 1996; 312: 327-328.
- World Health Organization.The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research.1993. Available at http://www.who.int/classifications/icd/en (accessed on 21 April 2009).
- American Psychiatric Association.Diagnostic and statistical manual of mental disorders.4th edition. APA, Washington, U.S.A.; 1994.
- Volkmar FR, Pauls D.Autism.Lancet. 2003; 362: 1133-1141.
- Folstein SE.Autism.International Review of Psychiatry. 1999; 11: 4.
- Lord C, Risi S, Pickles A.Trajectory of language development in autistic spectrum disorders.In: Rice M, Warren S (editors). Developmental language disorders: from phenotypes to etiologies. Lawrence Erlbaum Associates, Mahwah, U.S.A; 2004.
- Charman T, Taylor E, Drew A, et al.Outcome at 7 years of children diagnosed with autism at age 2: predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time.Journal of Child Psychology and Psychiatry. 2005; 46: 500-513.
- National Institute on Deafness and other Communication Disorders.Speech and language developmental milestones.Available at http://www.nidcd.nih.gov (accessed on 21 April 2009).
- Chakrabarti S, Fombonne E.Pervasive developmental disorders in preschool children.Journal of the American Medical Association. 2001; 24: 3093-3099.
- Baird G, Cass H, Slonims V.Diagnosis of autism.BMJ. 2003; 327: 488-493.
This information was last updated on May 01, 2009
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© BMJ Publishing Group Limited 2009. All rights reserved.
© BMJ Publishing Group Limited 2009. All rights reserved.
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